Individual
LACEY VANESSA ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 CENTENNIAL RD LOT 266, BISMARCK, ND 58503-0719
(701) 202-3536
Mailing address
2500 CENTENNIAL RD LOT 266, BISMARCK, ND 58503-0719
(701) 202-3536
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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